MORTALITY

WHAT IS MORTALITY?

Mortality is defined as being mortal or being susceptible to death. The opposite of mortality is immortality. Mortality
definition is the frequency of death in a given population. Out of the many other components of demography such as
demographic size, geographical distribution and composition, etc.
Mortality definition is used as a factor of change in demographic. Mortality as one of the components of demography is
measured as mortality rate. In simple terms, the rate of mortality definition states the death rate in a particularly given
region which brings changes in the demographics of that particular region. Hence, it is an important concept in the study
of population.
 W H AT I S T H E M E A N I N G O F M O R TA L I T Y R AT E ?

• Mortality meaning provides the basis for mortality rate and its estimation. Mortality is the possibility of and
susceptibility to death, and hence, the rate of mortality or the death rate is the measurement of the number of deaths that
occur in a particular population, scaled to the size of that population per unit of time. Globally, this rate is taken as the
measurement of the number of deaths per 1000 people per year. So, when the mortality rate is described as 11.5, it means
that in total 11.5 people have died per 1000 people in a given area for a given population. In percentage, it is expressed
as 1.15% of the total population.
• This concept is not to be confused with morbidity. Morbidity is either the prevalence or incidence of a disease. Hence,
the morbidity rate is the rate of disease in a population. Morbidity and mortality meaning is thus different in the sense
that morbidity is the condition of the prevalence of disease and mortality is the condition of death. For example, during
the COVID-19 pandemic, the morbidity rate increases with the spread of the disease amongst the population
 S TAT I S T I C S O F M O R TA L I T Y

• There are various causes of mortality. The causes of death influencing the components of demography differ greatly between the
developed and less developed countries. According to Jean Ziegler, who was a United Nations Special Rapporteur on the Right to
Food for 2000 to March 2008, stated that mortality is caused mainly due to malnutrition. The causes of death because of
malnutrition accounted for 58% of the total mortality in the year 2006. Another cause of death is age-related death. Of
approximately 1,50,000 people that die each day worldwide, almost two-thirds i.e. 1,00,000 per day die because of age-related
issues. In industrialized nations, this proportion is much higher and reaches almost 90%.

• Source : https://www.vedantu.com/geography/mortality
 MATERNAL MORTALITY

• The death of a woman during pregnancy, at delivery, or soon after delivery is a

tragedy for her family and for society as a whole.
 K EY FAC T S A B OU T M AT ER NA L M OR TA L I T Y B Y W H O

• Every day in 2020, almost 800 women died from preventable causes related to pregnancy and childbirth.
• A maternal death occurred almost every two minutes in 2020.
• Between 2000 and 2020, the maternal mortality ratio (MMR, number of maternal deaths per 100 000 live births)
dropped by about 34% worldwide.
• Almost 95% of all maternal deaths occurred in low and lower middle-income countries in 2020.
• Care by skilled health professionals before, during and after childbirth can save the lives of women and newborns.
• Sub-Saharan Africa and Southern Asia accounted for around 87% (253 000) of the
estimated global maternal deaths in 2020. Sub-Saharan Africa alone accounted for
around 70% of maternal deaths (202 000), while Southern Asia accounted for around
16% (47 000).

• At the same time, between 2000 and 2020, Eastern Europe and Southern Asia achieved
the greatest overall reduction in maternal mortality ratio (MMR): a decline of 70%
(from an MMR of 38 to 11) and 67% (from an MMR of 408 down to 134), respectively.
 WHERE DO MATERNAL DEATHS OCCUR?

• The high number of maternal deaths in some areas of the world reflects inequalities in access to quality health services
and highlights the gap between rich and poor. The MMR in low-income countries in 2020 was 430 per 100 000 live
births versus 12 per 100 000 live births in high income countries.

• In 2020, according to the Fragile States Index, 9 countries were “very high alert” or “high alert” (from highest to
lowest: Yemen, Somalia, South Sudan, the Syrian Arab Republic, the Democratic Republic of the Congo, the Central
African Republic, Chad, Sudan and Afghanistan); these countries had MMRs ranging from 30 (the Syrian Arab
Republic) to 1223 (South Sudan) in 2020. The average MMR for very high and high alert fragile states in 2020 was
551 per 100 000, over double the world average.

• Women in low-income countries have a higher lifetime risk of death of maternal death. A woman’s lifetime risk of
maternal death is the probability that a 15-year-old woman will eventually die from a maternal cause. In high income
countries, this is 1 in 5300, versus 1 in 49 in low-income countries.
 WHY DO WOMEN DIE?

• Women die as a result of complications during and following

pregnancy and childbirth. Most of these complications develop during
pregnancy and most are preventable or treatable. Other complications
may exist before pregnancy but are worsened during pregnancy,
especially if not managed as part of the woman’s care. The major
complications that account for nearly 75% of all maternal deaths
are (2):
• severe bleeding (mostly bleeding after childbirth);
• infections (usually after childbirth);
• high blood pressure during pregnancy (pre-eclampsia and eclampsia);
• complications from delivery; and
• unsafe abortion.
 WHY DO WOMEN NOT GET THE CARE
THEY NEED?

• Poor women in remote areas are the least likely to receive adequate health care. This is especially true for SDG regions with
relatively low numbers of skilled health care providers, such as Sub-Saharan Africa and Southern Asia.
• The latest available data suggest that in most high income and upper middle income countries, approximately 99% of all births
benefit from the presence of a trained midwife, doctor or nurse. However, only 68% in low income and 78% in lower-middle-
income countries are assisted by such skilled health personnel.
• Factors that prevent women from receiving or seeking care during pregnancy and childbirth are:
• health system failures that translate to (i) poor quality of care, including disrespect, mistreatment and abuse, (ii); insufficient
numbers of and inadequately trained health workers, (iii); shortages of essential medical supplies; and (iv) the poor accountability of
health systems;.
• social determinants, including income, access to education, race and ethnicity, that put some sub-populations at greater risk;
• harmful gender norms and/or inequalities that result in a low prioritization of the rights of women and girls, including their right to
safe, quality and affordable sexual and reproductive health services; and
• external factors contributing to instability and health system fragility, such as climate and humanitarian crises.
• To improve maternal health, barriers that limit access to quality maternal health services must be identified and addressed at both
health system and societal levels.
 INFANT MORTALITY RATES

• A live born child up to the completion of 365 days of life is called an infant. The
infant mortality rate is the number of deaths of infants under one year of age per
1000 live births in a given year.
• Infants are defined in demography as an exact age-group, namely, age 'zero', or
those children in the first year of life, who have not yet reached age one. Infant
mortality rate (IMR) is a measure of mortality among infants. It is customarily
defined or computed as the ratio of the infant deaths (deaths of children in the
Chant first year of life or under one year of age) registered in a calendar year to
the number of live births registered in the same year, usually multiplied by 1000.
 INFANT MORTALITY RATES

• Neo-natal mortality rate is the infant deaths that occur before the
completion of one month of age.
• Post-neo-natal mortality rate is the infant deaths that occur
between first and eleven completed months.
• Peri-natal mortality rate The exact definition of perinatal
mortality varies from country to country.
 W HAT A RE T HE RE A S O N S F OR T H E H I GH C H IL D M O RTA L I T Y R AT E
I N I N D I A?

• Despite significant progress in recent years, India continues to have

considerable issues with child mortality. India’s under-five mortality rate is
the highest in the world. Around 1.3 million newborns die every year in the
country during or immediately after delivery. According to the national Health
Ministry, India’s current newborn mortality rate stands at 29 per 1,000 live
births. High child mortality has been a long term issue in India due to various
reasons like poor maternal health and poverty in families.
1. Poverty: A major factor that leads to a high rate of infant mortality is poverty. 21.9% of Indians are
below the poverty line (BPL). Poor people are unable to get good healthcare services. They tend to get
babies delivered at home through local nurses known as dais and quack doctors. This endangers a child’s
life and often leads to infections due to unhygienic conditions in which the baby is delivered.
2. Malnutrition: Low birth weight is the leading cause of neonatal death, which drives up the under-five
mortality rate. Low birth weight can be caused by many factors. Foremost among these are poor
nutritional intake during pregnancy and a lack of healthcare, both before and during the birth.
3. Access to healthcare: Increasing access to affordable healthcare is critical to prevent child mortality. In
India, there are great disparities in the levels of access to healthcare. The allopathic doctor-patient ratio at
1:1445, which is lower than the prescribed ratio of 1:1000 by WHO. This is notable between urban and
rural regions of the country. Lack of access to healthcare both during and after the pregnancy have severe
consequences to the health of the child and lead to deaths.
4. Air pollution: India’s children are at severe risk of health issues due to air pollution. Around 93% of
children are regularly exposed to air pollution levels considered dangerous to their health according to
the World Health Organization (WHO). High levels of pollution are exposing India’s children to risks that
may not contribute to mortality in early life, but cause lifelong conditions that significantly reduce their
life expectancy.
5. Illiteracy: Education still remains low on priority in rural areas. According to
Comprehensive National Nutrition Survey data, 53% of the mothers surveyed had no
education at all. Only 20% of mothers of preschool children, 12% of mothers of school
going children and 7% of mothers of adolescents had completed 12 years of schooling.
Thus, new mothers and pregnant women lack the basic fundamentals of pregnancy as well as
post baby care. With no knowledge about immunisation of children, it exposes children to
greater risk of diseases leading to morality.
6. Sanitation: Another major reason is that many women do not have sufficient access to
clean water, nutritious food and regular medical assistance. This endangers the life of the
child and mother and exposes them to risk of infections.
7. Gender discrimination: The health of the girl child is neglected as they are seen as
burden. Due to this many girls die due to malnutrition and/or infectious diseases. Meta-
preference for sons leads to neglect of girls and their immunisation exposing them at higher
risk.
 MEASURES TO CONTROL CHILD MORTALITY
IN INDIA

1. Awareness: Education campaigns to aware mothers of importance of institutional delivery, exclusive breast feeding, immunisation, home
care for diarrhoea are needed. All these should create awareness among family members to provide support to women during pregnancies
and deliveries.
2. Gender sensitisation: The issue of neglect of the girl child is much broader and needs interventions beyond health. Focus should be on
addressing the social norms and cultural practices. There is an urgent need to ensure equitable access to care for the newborn girl.
3. Nourishment: Low birth weight can be prevented if the mother is well-nourished. Mothers should be taught about the importance of
breastfeeding. National food security scheme should include more nutritious food to pregnant ladies at subsidised prices.
4. Quality healthcare: Addressing gaps in quality of health care is the need of the hour in India. Hospitals should ensure that the critical
products to save the newborns are available. Capacity building of healthcare providers to train doctors, nurses and ANMs auxiliary nurse
midwives for early diagnosis and care of the mother during pregnancy and delivery is important.
5. Sanitation: Swachh Bharat campaign is a noble effort for improving sanitation in India. Efforts must be made to make and keep hospitals,
surrounding areas Swachh. It is important that rural people must be motivated to use toilets built under Swachh Bharat. Further, quacks
and local nurses dais must be trained and educated about the importance of sanitation.
6. Community involvement: Communities at local level must be involved with an aim to target immunisation of newborns and mother.
Female education and involvement is a must and they must be taught about the importance of immunisation programmes.
7. Improving climate conditions: Rural people must be educated about the harm of firing woods openly for food preparation.
Simultaneously, they must be encouraged to use LPG. Ujjwala Yojana is a good initiative but its penetration must be increased. Further,
refilling of LPG cylinder must be subsided.
 F E M A L E I N FA N T I C I D E

• Female infanticide is the intentional killing of baby girls due to the preference for male babies and
from the low value associated with the birth of females.’ These practices arise in areas where
cultural norms value male children over female children.
Facts on female Infanticide
• India is the only large country in the world where more girl babies die than boy babies. The
gender differential in child survival is currently 11 per cent.
• Between 2013 and 2017, about 460,000 girls in India were missing’ at birth each year. According
to one analysis, gender-biased sex selection accounts for about two-thirds of the total missing
girls, and post-birth female mortality accounts for about one-third. (The State of World Population
2020)
• The United Nations says an estimated 2,000 unborn girls are illegally aborted every day in India.
• Statistics reflect community attitudes with fewer hospital admissions for girls than boys, showing
that parents sometimes give less attention to girl newborns. In 2017 alone 150,000 fewer girls
were admitted to SNCUs than boys.
Hidden danger
Increasing female foeticide in India could spark a demographic crisis where fewer women in society will result in a rise in
sexual violence and child abuse as well as wife-sharing, the United Nations warned. This in turn will deteriorate the social
value system and can cause crisis situation
Causes
• However this anti-female bias is by no means limited to poor families. Much of the discrimination is to do with cultural
beliefs and social norms. These norms themselves must be challenged if this practice is to stop.
• The practice of female de-selection in India could be attributed to socio-economic reasons. Studies in India have
indicated three factors of female de-selection in India, which are economic utility, sociocultural utility, and religious
functions.
• The factor as to economic utility is that studies indicate that sons are more likely than daughters to provide family farm
labor or provide in or for a family business, earn wages, and give old-age support for parents.
• Upon marriage, a son makes a daughter-in-law an addition and asset to the family providing additional assistance in
household work and brings an economic reward through dowry payments, while daughters get married off and merit an
economic penalty through dowry charges.
• The sociocultural utility factor of female de-selection is that, as in China, in India's patrilineal and patriarchal system of
families is that having at least one son is mandatory in order to continue the familial line, and many sons constitute
additional status to families.
• The final factor of female de-selection is the religious functions that only sons are allowed to provide, based on Hindu
tradition, which mandate that sons are mandatory in order to kindle the funeral pyre of their late parents and to assist in
Steps initiated by Government
The government has initiated many steps and to bring an end to this social
evil, and to bring a change in the attitudes of the people in society. It is in this
direction that many laws, Acts and schemes have been initiated, such as the
following areas :
• The Laws favouring Girl Education
• The Laws favouring Women's right
• The Laws favouring Equal Property Share for a daughter
• Other schemes for girl child
Kindly refer following links

1.To be born a woman in India. Foeticide

and infanticide: origins, consequences and solutions.
2.Newborn Mortality